Provider Demographics
NPI:1386205946
Name:COUNTRYWIDE TRANSPORTATION
Entity Type:Organization
Organization Name:COUNTRYWIDE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-438-8124
Mailing Address - Street 1:3104 RAINBURST LN
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-7495
Mailing Address - Country:US
Mailing Address - Phone:832-438-8124
Mailing Address - Fax:
Practice Address - Street 1:3104 RAINBURST LN
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7495
Practice Address - Country:US
Practice Address - Phone:832-438-8124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)